Case-13425 Gallery

Before and after bilateral DIEP flap in a 45 year old breast cancer survivor. She had previously undergone bilateral skin sparing mastectomies with removal of her nipples and tissue expander reconstruction.

Although she had asked about using her own tissue for reconstruction, local surgeons did not perform this surgery and she was not encouraged to go elsewhere for her breast reconstruction. She was very upset to later learn about the DIEP flap – and dismayed her surgeon did not describe this to her as an option!

Her tissue expanders were painful and did not look symmetric or natural. She completed her cancer treatment, took a few years off and finally was ready for a revision of her breast reconstruction. She didn’t have to look far to find a Reconstructive Microsurgeon just a few hours away!

She had an overabundance of lower abdominal skin and fat. She was an ideal candidate for DIEP flap breast reconstruction! Her implants were removed, her pectoralis major muscles were returned to the chest wall, reconstructing her muscular anatomy.

Skin and fat was microsurgically transplanted from the lower abdomen to her chest as deep inferior epigastric artery perforator (DIEP) flaps. One artery and two veins were reconnected under the microscope to reestablish arterial inflow and venous outflow into and out of the flap tissue. In order to create a natural breast shape, some skin from her lower abdomen was left exposed on the chest, as a “skin paddle” or “skin island”.

She later underwent nipple and areola reconstruction at a second procedure together with fat grafting and other minor scar revisions for the best aesthetic results. Follow up photos are shown 4 years after her DIEP flap and 3 months after her revision. Her scars, which were naturally hypertrophic, are finally fading and softening after several years of scar therapy.

She looks normal and natural, and “feels like a woman again” – the results speak for themselves! She finally can move forward with her life as a Mom and professional without the obvious reminder of breast cancer she previously endured.